Ernest William Hey Groves and his contributions to orthopaedic surgery.

Ernest William Hey Groves was the son of an English civil engineer and was born in India on 20th June 1872. At the age of three, when his father retired, the family settled in Bristol. He inherited an aptitude for mechanics and took a B.Sc. in engineering. In London, while pursuing his science course, he saw an advertisement for a scholarship at St. Bartholomew's Hospital, London, which included the exact subjects which he was studying in his science degree. He entered for this scholarship as he said 'for a lark' and was successful. Neither his parents, nor his uncle with whom he lived, gave him

Delighted at receiving a definite diagnosis, the lady insisted that Hey Groves should remove the cyst himself. He had no nursing home or hospital facilities at that time and indeed, possessed no surgical instruments! He improvised a room at his home and with the help of his wife, who had been a nurse at St. Bartholomew's Hospital, the operation was successfully accomplished. This remarkable achievement Paper read to the Royal College of Surgeons of England on 30th September, 1981, and to the Bristol Medico-Chirurgical Society in November 1981. earned Hey Groves a reputation and he then ran his own nursing home and with no surgical training, removed appendices, prostates and gall bladders. He use to say that the first gastroenterostomy he ever saw was one performed by himself. Such was his growing reputation that he was appointed to the surgical staff of the Bristol General Hospital in 1903. He obtained his Fellowship in 1905 and an M.S.
with Gold Medal in the same year.
For four years he retained a share in the Kingswood practice, cycling there each morning and returning each afternoon to the Bristol General Hospital where he was consulting surgeon in charge of outpatients. During this early part of his career it was said, perhaps unkindly, that 'butcher Groves lured women into his home, operated upon them and would not remove their stitches until they had paid their money'. Then (Figure 2). The principles of treatment of fractures of the shaft of the femur, later ascribed to Kiintscher, are very clearly illustrated in this book, although Hey Groves believed in fixation of the fracture with a bone peg rather than an intra-medullary nail ( Figure 3). He stated that 'delay in union is a possible, though exceptional result of perfect operative fixation of a fracture'.3 It is remarkable that this was written in Intra-medullary fixation of a fracture. (Copy of Figure 271 avoid the dangers of a publication in London where the rivalry of the great schools has often prevented concerted effort'.5 The first edition appeared in July 1913. Hey Groves did an enormous amount of tedious editorial work, including the translation of scientific articles from France and Germany and after 20 years' service, he was presented with a silver salver by Lord Moynihan under whose guidance and affection he had worked. In October 1914, the Editorial Committee seriously debated whether it was worthwhile continuing a surgical journal at that crisis in history but fortunately this was not agreed and special articles dealing with military surgery were accepted and these established the reputation of the Journal and proved to be its salvation. The war gave Hey Groves a great impetus to pursue the surgery of bones and joints. First, there was a great wealth of material (he wrote a small book on Gunshot Injuries to Bones) and second, the organisation of orthopaedic work brought him into contact with Sir Robert Jones and 'under the sway of his gentle but compelling genius'. Hey Groves later said of the 1914-18 war, 'apart from the horrors and tragedy, they were gloriously happy years'. He appreciated particularly the camaraderie of the profession; English, French, American and Canadian surgeons all working together.
He described his own splint for the treatment of fractures of the lower limb, the principles of which are still in universal use today. Many do not realise that Hey Groves was the originator of the principle of the Stryker frame for the treatment of bullet wounds of the spine and paraplegia (Figure 4). He wrapped the patients in this type of collapsible device and turned them over in exactly the same way as is advocated today.
On 28th November 1917, Hey Groves was one of that small group of surgeons who met for dinner at the Cafe Royal in London. As a result of this meeting, the British Orthopaedic Association was founded but Hey Groves was still regarded by some as a general surgeon and was not originally invited to become a member. However, at the invitation of Sir Robert Jones, he had already taken surgical charge of the Military Orthopaedic Centre in Bristol and it was not long before the Association made amends by sending a special invitation to Hey Groves, asking him to join in the capacity of an original member.   of ankylosis of the hip was also discussed and there follows a description of how to perform an arthroplasty of the hip through an antero-lateral exposure with the use of the capsule of the joint as an envelope for the end of the femur (Figure 6). He also illustrated one of the first arthroplasties of the hip using an ivory nail to replace the arthritic head (Figure 7). In 1928, the famous Robert Jones Birthday Volume was published and in it Hey Groves wrote a chapter on Congenital dislocation of the hip joint. He commenced with the classical sentence: 'Congential dislocation of the hip is a deformity which is mysterious in its origin, insidious in its course and relentless in its final crippling results'.9 He included diagrams of his operation for deepening the shallow acetabulum in the adolescent child which was later described and popularised by Colonna. The voluminous capsule is dissected free, divided and the cut edges sutured over the head of the femur, thus preventing fibrous union. The acetabulum is then deepened, the sutures passed through its base and an arthroplasty of the hip performed with the head of the femur covered by its own capsule (Figures 8 and   9). Ernest Hey Groves was a great pioneer and original thinker and played a considerable part in the development of orthopaedic and traumatic surgery as we know it today. He gave a Presidential Address to the Medico-Chirurgical Society of Bristol in 1932 entitled, 'A Surgical Adventure' and in it he said 'Life must always be somewhat of an adventure, a mysterious reaction of the personality to the environment'.10 His judgement was sound; his technique Arthroplasty of the hip, showing exposure of the neck of the femur by division of the capsule. Inset